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Evaluating the Efficacy of CPS, HEART and TIMI Score in Emergency Department Patients with Non-Traumatic Chest Pain:
Pietro Pozzessere1, Mattia Di Lauro2,3, Francesco Incantalupo1
1Department of Emergency Medicine, University Hospital of Bari, 70124 Bari, Italy.
Insights
The HEART score demonstrated superior accuracy in predicting major adverse cardiovascular events (MACE) in chest pain patients compared to the chest pain score and TIMI risk score. This finding aids in risk stratification for better patient outcomes.
Area of Science:
- Cardiology
- Emergency Medicine
- Clinical Risk Assessment
Background:
- Accurate identification and risk stratification of chest pain patients are crucial for timely intervention.
- Major adverse cardiovascular events (MACE) pose a significant threat, necessitating reliable predictive tools.
Purpose of the Study:
- To evaluate the validity and prognostic accuracy of the chest pain score, HEART score, and TIMI risk score.
- To compare the performance of these scores in predicting MACE in emergency department patients presenting with chest pain.
Main Methods:
- A prospective study included 102 adult patients with atraumatic chest pain.
- The chest pain score, HEART score, and TIMI risk score were calculated for each patient.
- A 30-day follow-up assessed the incidence of MACE, including myocardial infarction, revascularization procedures, and death.
Main Results:
- The HEART score achieved the highest Area Under the Curve (AUC) of 0.9757.
- The TIMI risk score showed an AUC of 0.9378, followed by the chest pain score with an AUC of 0.8312.
- Out of 102 patients, 26 experienced MACE within 30 days.
Conclusions:
- All three scores are effective in predicting MACE in chest pain patients.
- The HEART score exhibited superior prognostic accuracy compared to the chest pain score and TIMI risk score.
- These validated scores can aid clinicians in managing patients with chest pain in the emergency setting.
Background And Aim:
The correct identification of patients presenting with chest pain and the stratification of their risk for major adverse cardiovascular events (MACE) is essential. The aim of this study was to evaluate subjects who came to the ED for chest pain through the chest pain score, the HEART score and the TIMI risk score in order to assess their validity and prognostic accuracy and to compare their performance.
Methods:
Patients included in the study met the following criteria: age ≥18 years, reported atraumatic chest pain, and consent to participate in the clinical study. Subsequently, the final scores were calculated based on the information collected and a follow-up was performed to assess the occurrence of adverse cardiovascular events (MACEs) at 30 days. The MACEs considered were a composite endpoint of STEMI or NSTEMI myocardial infarction, positive coronary angiography for critical lesions, percutaneous coronary angioplasty, coronary artery bypass grafting, and death.
Results:
A total of 102 patients were included in the study sample, divided into 76 patients who did not develop MACEs and 26 patients who experienced MACEs. The AUC values of the ROC curves of the chest pain score, HEART score and TIMI risk score were 0.8312, 0.9757 and 0.9378 respectively.
Conclusions:
All three scores examined were considered excellent tools to predict the onset of MACEs in patients with chest pain at different points of clinical management, although the HEART score outperformed both the chest pain score and the TIMI risk score in terms of prognostic accuracy.
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